To date, islet allografts have been performed in seven diabetic patients already on immunosuppression because of a previously placed renal allograft. Although a period of reduced insulin requirements occurred following most of the transplants, donor-recipient pairs were poorly matched for HLA antigen, rejection occurred, and all patients remained diabetic. During the past year, 32 diabetic patients who have received or are to receive a kidney allograft have been characterized according go HLA typing, carbohydrate metabolism, and individual C-peptide response to glucose stimulation. These patients form a prospective islet recipient pool that will receive islet allografts from cadaver donors matched to the recipient for 2 or more HLA antigens. During the past year, one patient with chronic pancreatitis was treated with near total (greater than 95%) pancreatectomy and autotransplantation (via the portal venous system) of islets prepared from the excised pancreas. This individual has remained normoglycemic as a result of the islet autograft. The success with the islet autograft establishes the technical feasibility of clinical islet transplantation, allowing future efforts to be focused on the immunological aspects of islet allografts. Pancreatic islet autotransplantation will be offered to other individuals requiring pancreatectomy for benign disease such as intractable pain from chronic pancreatitis or from severe trauma. BIBLIOGRAPHIC REFERENCES: Matas, A.J., Sutherland, D.E.R., and Najarian, J.S.: The Current Status of Islet and Pancreas Transplantation in Diabetes. Diabetes. 25:785-795, 1976.